The application of vitrification in human blastocyst cryopreservation: Analysis of clinical outcome of 117 cycles

Objective: To summarize the clinical outcomes of 117 human vitrified blastocyst transfer cycles and to determine the impact factors.Methods: In IVF-ET cycles, supernumerary embryos were cultured to 5-Day(D5) or 6-Day(D6), blastocysts of various stages were cryopreserved by vitrification using cryoloops. Survival rate and clinical pregnancy rate were observed.Results: A total of 312 blastocysts were thawed in 117 frozen embryo transfer cycles, the survival rate was 90.7% (283/312) after thawing. After the transfer of 230 blastocysts in 115 cycles, 69.6% (80/115) of the women got clinically pregnant, and 17.5% (14/80) of them suffered from miscarriage, 39 healthy babies were born in 28 deliveries, and the other 38 pregnancies are ongoing. The implantation rate was 47.4% (109/230). In 107 transfer cycles with 2 hatched blastocysts transferred in each cycle, 72.9% (78/107) got clinically pregnant, while in 8 cycles with 1 or no hatched blastocysts in the two transferred blastocysts, the clinical pregnancy rate is 25%(2/8). The clinical pregnancy rates were not statistically different between natural (77.4%, 24/31) or artificial endometrium preparation (66.7%, 56/84) cycles. Conclusions: These findings suggest that blastocyst vitrification is effective in terms of implantation rate and pregnancy outcome. Transferring of two hatched blastocyst can achieve a higher pregnancy rate.     

桥本氏病手术治疗45例临床分析

本文分析４５例桥本氏病诊断和手术治疗的经验教训。本病合并其它甲状腺外科疾病 诊断困难，手术方式要慎重选择。术中常规冰冻快速活检，可帮助鉴别诊断和指导术式选择。     

肺心病血液光量子治疗前后血液流变性质变化及机制探讨

１５例肺心病血液高粘滞患者自体血２５０ｍｌ用ＸＺＹ－Ⅰ型量子血液治疗机进行紫外线照射和充以纯氧后再输入，每周一次，最多连续做三次（平均１．８６±０．７１次）后，作者发现血液全血高切、低切粘度，全血高切、低切还原粘度，血浆比粘度，血浆纤维否白原含量，红细胞聚集指数，红细胞电泳率等有显著性改变，单纯常规治疗组１５例患者血液流变无此变化，分析认为，这些变化可能与红细胞聚集性降低、纤维蛋白源溶解度提高及血氧饱和度增加有关。     

Treatment of refractoriness to platelet transfusion by protein A column therapy

Ten thrombocytopenic patients (platelets < 10–24 × 10(9)/L) who were refractory to platelet transfusion were investigated for their responsiveness to staphylococcal protein A column therapy. Nine patients had previously been treated with steroids, intravenous immune globulin, and/or other forms of immunosuppressive therapy without improvement in their transfusion response. All patients were receiving multiple platelet transfusions without achieving 1-hour corrected count increments (CCIs) > or = 7500. Eight patients had antibodies that reacted with platelets and were directed against HLA class I antigens, ABO antigens, and/or platelet-specific alloantigens. Plasma (500-2000 mL) from each patient was passed over a protein A silica gel column and then returned to the patient. Patients received from 1 to 14 treatments. A positive response to protein A therapy was defined as at least a doubling of the pretreatment platelet count and/or two successive 10- to 120-minute posttransfusion CCIs > or = 7500. Following plasma treatments, 6 of 10 patients responded with daily platelet counts that averaged 48 +/− 11 × 10(9) per L as compared with counts of 16 +/− 7 × 10(9) per L (p < 0.0005) before treatment. Posttransfusion CCI values determined in four of these patients averaged 2480 +/− 810 and 10,010 +/− 3540 (p < 0.005) before and after treatment, respectively. In contrast, among the four unresponsive patients, platelet counts averaged 10 +/− 9 and 13 +/− 10 × 10(9) per L (p = NS), respectively, while posttransfusion CCIs were 700 +/− 1410 and 1520 +/− 2460 (p = NS), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

旋毛虫、卫氏并殖吸虫及华支睾吸虫之间共同抗原的研究

目的鉴定旋毛虫、卫氏并殖吸虫及华支睾吸虫之间的共同抗原,避免血清学诊断这3种寄生虫病时的交叉反应。方法应用十二烷基硫酸钠-聚丙烯酸胺凝胶电泳(SDS-PAGE)和免疫印渍(Western blot)对旋毛虫肌幼虫、卫氏并殖吸虫成虫及华支睾吸虫成虫可溶性抗原中的蛋白组分进行研究。结果旋毛虫肌幼虫、卫氏并殖吸虫成虫及华文睾吸虫成虫3者相同蛋白带的分子量为108、65、53、43、42、31、25、16 kDa。免疫印渍结果表明,旋毛虫和卫氏并殖吸虫抗原中分子量为 65、58、53kDa的蛋白带均与旋毛虫感染的大鼠、小鼠及患者血清、肺吸虫感染的大鼠和患者血清发生反应;旋毛虫和华支睾吸虫抗原中分子量为108kDa的蛋白带均与旋毛虫感染的大鼠、小鼠及患者血清、肝吸虫病患者血清发生反应;而3种可溶性抗原中的53kDa与本实验中所有寄生虫感染的动物和患者均有交叉反应。结论 65、58、53 kDa蛋白为旋毛虫和卫氏并殖吸虫的共同抗原,108kDa蛋白为旋毛虫和华支睾吸虫的共同抗原,而53 kDa蛋白为这3种寄生虫的共同抗原。     

体外静脉—静脉转流下原位肝移植围术期酸碱,生化的变化

目的:观察体外静脉转流下原位肝移植围术期酸碱和生化的变化。方法:7例病人行原位肝移植术,在无肝期行体外静脉-静脉转流,监测围术期酸碱和生化指标。结果:(1)与术前相比,pH各期有所下降,但仍维持在正常范围,BE和SBC在转流60分钟及关腹时降低;与转流前期相比。pH以后各期变化不大。术期pH在7.35～7.45范围之内;(2)血糖在各期都升高,血钙降低,体温逐渐降低;(3)血钾在肝血管开放后一过性增高,由3.17mmol/L升至3.53mmol/L。结论;体外静脉转流下原位肝移植术,术中酸碱和生化变化轻微,避免了明显的代谢性酸中毒和高血钾,但体温和血糖变化明显。     

脂质体携载SOD的实验研究

本文采用去垢剂透析法成功制备出携载ＳＯＤ的脂质体（Ｌ－ＳＯＤ），其直径为１０２ｎｍ，对ＳＯＤ的包裹率为２１％，９０％以上酶活性存在于脂质体内部。将Ｌ－ＳＯＤ注射到大鼠静脉血中，其半衰期超过４ｈ，明显长于天然ＳＯＤ（８ｍｉｎ）。表明Ｌ－ＳＯＤ优于天然ＳＯＤ，具有临床应用前景。     

嗜肺军团菌聚合酶链反应检测方法及其应用研究

根据嗜肺军团菌基因组ＤＮＡ的种特异性ＤＮＡ片段序列，合成一对引物进行聚合酶链反应（ＰＣＲ）。经琼脂糖凝胶电泳、ＥＢ染色结果表明，一条８７０ｂｐ的核苷酸区带为嗜肺军团菌１～１４血清型菌株所共有。ＰＣＲ检测水中军团菌，其敏感性为３５０ｃｆｕ／ｍｌ，而用同位素标记探针、斑点杂交法检测，其敏感性为４３ｃｆｕ／ｍｌ。ＰＣＲ检测人工感染嗜肺军团菌的豚鼠组织标本，阳性率为８３．３％，而细菌分离培养的阳性率仅为２６．６％。在现场调查中，用ＰＣＲ法初步验证了一起由Ｌｐ１０引起的军团菌病爆发。上述结果表明，ＰＣＲ法能快速、敏感、特异性检测嗜肺军团菌感染。     

创伤骨科中责任制护理初探

本文复习了有关责任制护理的理论，从创伤骨科的角度，介绍了这一护理技术在创伤骨科中具体应用方法。通过对创伤骨科病人心理及临床特点的分析，提出了针对创伤病人的护理问题，订出护理计划，在阐述了责任制护理具体实施的优点时，对现存的问题也进行了分析，提出了改进措施。